Allergies, body mass, and hospitalization due to arbovirus infection: A prospective surveillance study in Machala, Ecuador

Abstract

Dengue, chikungunya, and Zika are arboviruses that cause 390 million infections annually. Risk factors for hospitalization are poorly understood. Communities affected by these diseases have an escalating prevalence of allergies and obesity, which are linked to immune dysfunction. We assessed the association of allergies or body mass with hospitalization for an arbovirus infection. From 2014 to 2017, we recruited participants with a clinical diagnosis of arbovirus infection. Arbovirus infections were laboratory-confirmed and allergies were self-reported. Mid-upper arm circumference (MUAC), weight, and height were measured. We used two logistic regression models to assess the relationships between hospitalization and allergies and between hospitalization and body mass (MUAC for participants <20 years old and body mass index (BMI) for adults ≥20 years old). Models were stratified by age group and adjusted for confounders. For allergies, 41 of 265 were hospitalized. There was no association between allergies and hospitalization. For body mass, 34 of 251 were hospitalized. There was a 43% decrease in hospitalization odds for each additional centimetre MUAC among children (aOR 0.566, 95% CI 0.252-1.019) and a 12% decrease in hospitalization odds for each additional BMI unit among adults (aOR 0.877, 95% CI 0.752-0.998). Our work encourages the exploration of the underlying mechanisms.

Keywords: allergies; arbovirus; body mass; dengue; hospitalization.

Figure 1.

Flow chart of Selection for Allergy and Body Mass Analyses. Initial enrolment (bold black outline) included 592 participants; after exclusions, there were 265 participants for the allergy analysis (bold blue outline). Further exclusions left 251 participants for the body mass analysis (bold orange outline). DENV=dengue virus, CHIKV=chikungunya virus, ZIKV=Zika virus.